RESUMO
Break of a stent delivery catheter and subsequent stent loss (SL) has been a rare event in the drug-eluting stent (DES) era. We here report a case of successful retrieval of a stent after a break if the delivery catheter and SL from a balloon catheter at a culprit lesion. We finally resolved this situation using a simple balloon technique for both the broken stent catheter inside of the guide catheter and the unexpanded stent in the culprit lesion. Thus balloons are an important weapon in our armamentarium in the cardiac catheterization laboratory for urgent retrieval of a lost stent. Their apt use definitely allowed our patient to avoid undergoing emergency cardiovascular thoracic surgery.
RESUMO
Sudden stent loss after stent entrapment in a tight coronary lesion is an unexpected and devastating complication. Proper and timely steps without pressing the panic button are necessary. We describe a case of entrapment of a sirolimus-eluting stent into the left coronary artery system. Although the entrapped drug-eluting stent was successfully removed using a snare device, excessive guide manipulation under this life-threatening condition led to extensive left main and left circumflex artery dissection. This was immediately rescued by direct stenting to the left main and circumflex arteries. The usage of snare device in this bail-out situation was successful, safe and prevented emergency bypass surgery.
Assuntos
Angioplastia Coronária com Balão/efeitos adversos , Dissecção Aórtica/etiologia , Doença da Artéria Coronariana/terapia , Vasos Coronários/lesões , Stents Farmacológicos/efeitos adversos , Idoso , Dissecção Aórtica/diagnóstico por imagem , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Remoção de Dispositivo , Feminino , HumanosAssuntos
Estenose Coronária/terapia , Imunossupressores/uso terapêutico , Sirolimo/uso terapêutico , Stents , Acetilcolina , Angiografia Coronária , Estenose Coronária/diagnóstico por imagem , Dilatação Patológica/diagnóstico por imagem , Dilatação Patológica/terapia , Implantes de Medicamento , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Ultrassonografia de Intervenção , VasoconstritoresRESUMO
Despite the fact that the drug-eluting stents (DES) have markedly reduced neointimal proliferation, restenosis is still an open subject. Although DES fracture is very rare, it has been considered as one of the reasons for DES restenosis, however, the mechanism and proper management are not clearly elucidated yet. We describe two cases of sirolimus-eluting stent fracture combined with significant restenosis and suggest the possible revascularization strategies for successful management.